HomeMy Public PortalAbout9123 BLACKLEY ST_Building__ � � 8
76A638A CEH803 5-65 APPLICATION FOR BUILDI G PERMI
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS &,-, , ✓ C
BUILDING AND SAFETY"DIVISION LOCALITY T_
JOHN A LAMBIE COUNTY ENGINEER NEAREST
COLEMAN W JENKINS SUP T OF BUILDING CROSS ST _�^ -
DISTJ,CT O G TYPE PRO ES B
FOR APPLICANT TO FILL IN -'` ( CONST
BUILDING /(/)� �31a�� STATISTICAL C SI FICATION SBKER MPAG
PG -
CLASS� CLASS NO DWELL UNITS
LOT NO , BLOCK USE ZONE MAP
No
(� '
TRACT SPECIAL
NO OF BLDGS CONDITIONS
SIZE OF LOT �NO�jW ON LOT -
USESOF
N D@C/CII a ti l/`I BLDG SETBACK FROM
yy TEL p����P/Q FRONT PROP LINE OF ��/V (STREET)
OWNER rA641?//L.T Tnel rt I/ NO
BL 0(7o TYPE OF EXISTING SETBACK HIGHWAY _-+_ YARD 'TOTAL
ADDRESS G�1��3-y-F I3f o�lt.¢.o�f: lJ�v� HIGHWAY WIDTH FROM C L
/ V - +
CITY - _
ARCHITECT OR TEL BLDG SETBACK FROM _
ENGINEER NO SIDE PROP LINE OF (STREET)
TYPE OF EXISTING SETBACK- HIGHWAY + YARD- = TOTAL
ADDRESS HIGHWAY WIDTH FROM C L
TEL _ _ + _
CONTRACTOR -NO - - _ O
LIC CORNER CUTOFF YES NO a - V
ADDRESS NO
CITY , cls SEE REVERSE SIDE FOR SPECIAL APPROVALS O
DESCRIPTION OF WORK V� r� rte
NEW , DD ALTER, REPAIR DEMOLISH ,fes � ��
SO FT `- - NO OF NO OF i �1 �7�(,/�W�' C� _
SIZE STORIES FAMI LIE ,
USE CV
f?c.,s � ✓/�
STRUCTUR C'
SIGNATOR OF
APPLICANT
VALUATION$ �N��`®oar �n ✓ v
/// APPROVALS DATE INSPEC R'SSIGNATURE
P C ,PMT FOUNDATION, LOCATION
FEE$ FEE$ FORMS, MATERIALS
FRAME, FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FIURNACE LOCATION
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS
9U ILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT
TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT
ING TO WORKMEN 5 Cn PENSATION�N.4U RANCE
s-�J✓////g� , LATH EXT
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS 3
FI NAL d
JOHN F LEWI PRINCIPAL STR RAL ENGINEER
PLAN CHECK VALIDATION CK M O CASH _ PERMIT VALIDATION mc
CASH
LAt, 3 2 0 8- Jum 3 0 1 D v N c
t
/ A63! CE #803 1/71
C?
-� APPLICATION FOR BUILDING PE MIT
• y .COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL_ _
BUILDING AND SAFETY DIVISION ADDRESS -2 x•001 •_ /
COLEMAN W. JENKINS, SUP T OF BUILDING LOCALITY �w
FOR APPLICANT TO FILL IN- " _ "FOREST
(Print ort onl CROSS ST
DISTRICT GROUP TYPE ESSED B
BUILDING -� `/ ..�Lj"� CONST
ADDRESS
STATISTICAL CLAS FICATION SEWER,MAP
LOT NOvie
�J BLOCK ,CLASS NO DWELL UNITS - BFF�R6 +-
TRACTle s �"� .0 `^ - US ONE MAP
NO OF BLDGS NO �•(� _ _ _
SIZE OF LOT NOW ON LOT / SPECIAL
USE OF ` CONDITIONS
EXISTING BLDG '
TEL _
OWNER L 41 NO 5- BLDG SETBACK FROM
C G, FR NT PROP LINE OF - --Y _--_ — -(STREET)
ADDRESS C ' u
TYPE 0 SETBACK HIGHWAY + YARD = TOTAL
CITYTemple L+_'/ HIGHWAY STING FROM C L
ARCHITECT OFt TEL }
ENGINEER ) NO ---- --
BLDG SETBACK FROM
[APPLICANT
RESS �' SIDE PROP LINE OF (STREET)
_ TEL - - _ TYPE,OF EXISTING SETBACK HIGHWA + YARD = TOTAL a
TRACTOR] NO' ' HIGHWAY WIDTH FROM C L CCU
RESS 1 LIC r _
NO + - CD
LIC U
Y CLASS CORNER_CUTOFF _YES N__O wa
STRUCTION LENDER to
E AND BRANCH SEE REVERSE SIDE FO SPE IAL APPROVALS z
RESS ,
FT NO OF NO OF - NEW ❑ w 7L _ _
E STORIES FAMILIES _
OF ADD IQ z
UCTURE J
ALTER ❑ _
�� IC REPAIR❑
NA RE OF _
DEMOL UATION S APPROVALS DATE / INSPE�OR_S 5 NATURE
PC PMT c FOUNDATION LOCATION
FEE $ FEES 35 Z FORMS,IMA TER I A LS
FRAME FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS Y•Z�
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION,
WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT DUCTS
STRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH INT
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO - --
WORKMEN'S COMP NSATION INSURANCE , LATH, EXT
7_/
SIGNATURE OF HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRESS FINAL
JOHN F-LEWIS PRINCIPAL STRUcruR E
PLAN CHECK VALIDATION- CK M o CASH _ PERMIT VALIDATION CK
L&O 4 'a 8 6 v �v�R 1- 3 1 D 3 5.2 5� Q
DEPARTMENT OF BUILDING AND SAFETY APPL �TIi d �� I
COUNTY OF LOS ANGELES
WM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
4i I�1 F) e� DISTRICT NO PLANCK NO X�YPERMITN?OBUILDING /
ADDRESS ,o`y r` , �Ii�LC !I ' �/ .� c- fJ y Zv v .
✓/' J '7 RE IVED BY ;I. DATE OF APPL• DATE ISSUED
LOCALITY ?'���:i lJ �� { , "" t
NEAREST • t �/ ��2` :I �S Z
CROSS ST a�.��' �' f,.r�� ,��^LY BUILDING
ADDRESS Cil L.� I S
OWNER _
MAIL / ! r^ LOCALITY "
ADDRESS NEAREST T
TELj CROSS ST R FI✓0 ,y
CITY ,�trJ�/ J ,�{� 'r r NO /5 T ZFIRE NO OF ONE 'PLANS �--I TYPE I GROUP ,
ARCHITECT OR, TEL
ENGINEER - NO BLDG _O NO
_ SETBACK LINE 2-0
�--
ADDRESS APPROVED - -TEL BY DATE
CONTRACTOR' —NO USEI APPROVED '^ " .
ZONE / BY DATE
ADDRESS HOUSE NUMBERING
LEGAL
`DESCRIPTION_-I LOT NO 7 I BLOCK -- MAP NUMBER - FIELD CHECK BY
TRACT S S /Z—A3 NO ASSIGNED BYDATE
D
Op NO OF BLGS CORRECTIONS
SIZE OF LOTI Qa _ fI PRROX I NOW ON LOT I
USE OF /'e �� NOOF
EXISTING BLDG S , I FAMI LIES /
DESCRIPTION OF WORK
NEW I ALTERATION I I ADDITION I r
0
REPAIR I - I DEMOLITIONSoFT'
t7
NO OF
SIZE LO , ZO ROOMS STORIES / Y
EXT WALL ROOF r
COVERING (f T(f C�Q I COVERING
USE OF STRUCTURE / _
T/lV
APPROVA S
INSPECTO 'S SIGNATURE DATE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FOUNDATION LOCATION
PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS
CORRECT
I AGREETO COMPLY WITH THE CORRECTIONS LISTED FRAME FIRESTOPS, ���`
HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS 4
LAWS REGULATING BUILDING CONSTRUCTION
w FURNACE LOCATION,
SIGNATURE OF GAS VENT, DUCTS
PERMITTE
LATH, INTI
ADDRESS
I LATH, EXT - .�js—z-F,-7"Z._
AUTHORIZED AGT - -
PLASTER, INT
78A888A DBS3- 10-80 .�� /*D 90 P $
FEE
PLASTER, EXT '
VALUATION $
- FEE FINAL .�-� �L.�'a-7.
' I �